CPT code 54220: Corporal irrigation, priapism treatment2026 Medicare rate & RVUs in Kentucky

Reports irrigation of the corpora cavernosa to treat priapism, typically as an acute urologic intervention to clear blood from the corporal spaces.

CMS RVU26DEffective Oct 1, 2026One payment locality553 Medicare services in 2024

In Kentucky, Medicare pays $233.31 for 54220 in the office and $124.33 when it’s performed in a hospital or facility.

$233.31Office (non-facility)
$124.33Hospital or facility
−7.5%vs the national office rate ($252.18)

Check a contract rate as a % of Medicare · 54220 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 54220 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What 54220 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 54220 covers

This service involves irrigating the corpora cavernosa to treat priapism, usually a prolonged erection requiring urgent management. A urologist or other qualified physician may perform it in an emergency department, hospital, or office setting. The procedure may be part of a treatment sequence that also includes corporal aspiration or a separately performed intracavernosal medication injection.

Report 54220 when the documented service is corporal irrigation for priapism; distinguish it from pharmacologic injection alone or surgical drainage. The record should identify the priapism indication and describe the irrigation performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Kentucky compares for 54220

Across 109 of 109 payment localities, the office rate for 54220 runs from $222.79 in Arkansas to $324.46 in San Benito County, CA. Kentucky pays $233.31. The RVUs are the same everywhere; the geographic indexes change the dollars.

54220 in Kentucky vs other payment areas
  1. Kentucky · this page$233.31
  2. Los Angeles, CA · California$279.68+$46.37
  3. Washington, DC area · District of Columbia$286.36+$53.05
  4. Miami, FL · Florida$280.66+$47.35
  5. Chicago, IL · Illinois$272.12+$38.81
  6. Manhattan, NY · New York$291.39+$58.08
  7. Alaska · Alaska$295.48+$62.17

Other areas in Kentucky first, then benchmark localities. Bars start at $0.

Every other payment area

54220 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$226.07$118.81
ArkansasArkansas$222.79$117.50
ArizonaArizona$245.18$126.40
Bakersfield, CACalifornia$263.32$128.97
Chico, CACalifornia$262.12$127.77
El Centro, CACalifornia$262.19$127.84
Fresno, CACalifornia$262.12$127.77
Hanford, CACalifornia$262.12$127.77

54220 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$222.79

$295.48

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
54220 office rate range by state
State / territoryOffice rate rangeLocalities
AK$295.481
AL$226.071
AR$222.791
AZ$245.181
CA$262.12–$324.4629
CO$260.151
CT$269.011
DC$286.361
DE$249.211
FL$252.41–$280.663
GA$237.76–$257.842
GU$267.911
HI$267.911
IA$230.001
ID$231.891
IL$246.43–$272.124
IN$233.191
KS$229.791
KY$233.311
LA$233.29–$244.752
MA$258.95–$284.672
MD$253.70–$286.363
ME$234.03–$245.452
MI$240.20–$256.462
MN$246.681
MO$229.86–$244.573
MS$226.331
MT$252.151
NC$236.341
ND$243.651
NE$231.001
NH$256.901
NJ$271.35–$283.562
NM$241.871
NV$249.941
NY$239.96–$299.585
OH$238.461
OK$231.961
OR$247.28–$267.412
PA$238.35–$262.892
PR$253.711
RI$257.371
SC$237.941
SD$242.641
TN$231.061
TX$236.85–$259.928
UT$241.171
VA$245.25–$286.362
VI$253.711
VT$243.491
WA$258.20–$289.582
WI$235.561
WV$237.541
WY$248.441

See 54220 in every payment locality

How the 54220 rate is calculated

Each of 54220’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 54220

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.36

2.36 RVUs× 1.000 GPCI

Practice expense4.76

4.76 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

7.5500

Conversion factor

$33.4009

Medicare rate

$252.18

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,262

Code
54220
Physician work
2.36
Practice expense
4.76
Malpractice
0.43

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 54220 in Kentucky
ComponentRVULocality factorAdjusted
Physician work2.36× 1.0002.3600
Practice expense4.76× 0.8894.2316
Malpractice0.43× 0.9150.3935
Total RVUs6.9851
Conversion factor× 33.4009

Office rate, Kentucky$233.31

Office: (2.36 × 1 + 4.76 × 0.889 + 0.43 × 0.915) × $33.4009 = $233.31

Facility: (2.36 × 1 + 1.09 × 0.889 + 0.43 × 0.915) × $33.4009 = $124.33

Open 54220 in the RVU calculator

Payment rules and modifiers for 54220

The CMS indicators that decide how 54220 is paid alongside other services.

CMS payment indicators · 54220

Corporal irrigation, priapism treatment

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

54220 without 51 · national office

$252.18

Corporal irrigation, priapism treatment

54220-51 · Second procedure: 50%

$126.09

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 54220 has changed in Kentucky

54220 · Office / nonfacility

$233.31

Effective 2026-10-01

The base rate is $33.45 higher than on 2025-10-01, moving from $199.86 to $233.31 (16.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $199.86changed to$233.31

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.42 changed to 2.36
    • Practice expense RVU 3.88 changed to 4.76
    • Malpractice RVU 0.39 changed to 0.43
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $206.27changed to$199.86

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.89 changed to 3.88
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $202.91changed to$206.27

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $205.04changed to$202.91

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.79 changed to 3.89
    • Malpractice RVU 0.37 changed to 0.40
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913
  5. January 1, 2023

    RVU23A

    $206.51changed to$205.04

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.73 changed to 3.79
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $206.42changed to$206.51

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.68 changed to 3.73
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $201.82changed to$206.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.30 changed to 3.68
    • Malpractice RVU 0.35 changed to 0.36
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $199.12changed to$201.82

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.24 changed to 3.30
    • Malpractice RVU 0.31 changed to 0.35
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $197.68changed to$199.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.22 changed to 3.24
    • Malpractice RVU 0.29 changed to 0.31

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $193.94changed to$197.68

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.13 changed to 3.22
    • Malpractice RVU 0.30 changed to 0.29
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $191.66changed to$193.94

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.09 changed to 3.13
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $192.64changed to$191.66

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.31 changed to 0.30

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $191.68changed to$192.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $188.58changed to$191.68

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.04 changed to 3.09
    • Malpractice RVU 0.25 changed to 0.31
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $185.89changed to$188.58

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.27 changed to 3.04
    • Malpractice RVU 0.26 changed to 0.25
    • Practice expense GPCI 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $185.89

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$233.31$124.33RVU26D
2026-07-01$233.31$124.33RVU26C
2026-04-01$233.31$124.33RVU26B
2026-01-01$233.31$124.33RVU26A
2025-10-01$199.86$124.40RVU25D
2025-07-01$199.86$124.40RVU25C
2025-04-01$199.86$124.40RVU25B
2025-01-01$199.86$124.40RVU25A
2024-10-01$206.27$127.74RVU24D
2024-07-01$206.27$127.74RVU24C
2024-04-01$206.27$127.74RVU24B
2024-03-09$206.27$127.74RVU24AR
2024-01-01$202.91$125.66RVU24A
2023-10-01$205.04$126.94RVU23D
2023-07-01$205.04$126.94RVU23C
2023-04-01$205.04$126.94RVU23B
2023-01-01$205.04$126.94RVU23A
2022-10-01$206.51$127.72RVU22D
2022-07-01$206.51$127.72RVU22C
2022-04-01$206.51$127.72RVU22B
2022-01-01$206.51$127.72RVU22A
2021-10-01$206.42$128.49RVU21D
2021-07-01$206.42$128.49RVU21C
2021-04-01$206.42$128.49RVU21B
2021-01-01$206.42$128.49RVU21A
2020-10-01$201.82$132.11RVU20D
2020-07-01$201.82$132.11RVU20C
2020-04-01$201.82$132.11RVU20B
2020-01-01$201.82$132.11RVU20A
2019-10-01$199.12$132.52RVU19D
2019-07-01$199.12$132.52RVU19C
2019-04-01$199.12$132.52RVU19B
2019-01-01$199.12$132.52RVU19A
2018-10-01$197.68$132.73RVU18D
2018-07-01$197.68$132.73RVU18C
2018-04-01$197.68$132.73RVU18B
2018-01-01$197.68$132.73RVU18AR1
2017-10-01$193.94$132.01RVU17D
2017-07-01$193.94$132.01RVU17C
2017-04-01$193.94$132.01RVU17B
2017-01-01$193.94$132.01RVU17A
2016-10-01$191.66$130.78RVU16D
2016-07-01$191.66$130.78RVU16C
2016-04-01$191.66$130.78RVU16B
2016-01-01$191.66$130.78RVU16A
2015-10-01$192.64$131.54RVU15D
2015-07-01$192.64$131.54RVU15C
2015-04-01$191.68$130.88RVU15B
2015-01-01$191.68$130.88RVU15A
2014-10-01$188.58$129.23RVU14D
2014-07-01$188.58$129.23RVU14C
2014-04-01$188.58$129.23RVU14B
2014-01-01$188.58$129.23RVU14A
2013-10-01$185.89$125.44RVU13D
2013-07-01$185.89$125.44RVU13C
2013-04-01$185.89$125.44RVU13B
2013-01-01$185.89$125.44RVU13AR

Price 54220 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

54220 billing questions

How is 54220 different from 54235?

54220 represents irrigation of the corpora cavernosa for priapism. 54235 represents injection of a pharmacologic agent into the corpora cavernosa; report it only when that injection is a distinct service.

Is irrigation included in surgical drainage under 54420?

54420 describes surgical drainage of the corpus cavernosum for priapism, with or without irrigation. Choose the code that reflects the procedure actually performed; do not separately characterize irrigation that is part of the surgical drainage service.

Does 54220 have a postoperative global period?

It has a 0-day global period. Same-day preoperative and postoperative care is included.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are other procedures in the same session paid?

CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 54220PPRRVU2026_Oct_nonQPP.csv, line 6,262 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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